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The birth control shot (otherwise known as Depo-Provera) and birth control pills are highly effective and safe methods of contraception. However, each form is very different.

The biggest similarity is that both birth control pills and the birth control shot contain hormones that prevent ovulation. A major difference is that birth control pills must be taken daily, while Depo-Provera is administered by a healthcare professional once every 3 months.

Each form comes with its own set of pros and cons, although some side effects, like spotting and breast tenderness, can overlap.

The best choice for you depends on your:

  • medical history
  • personal preference
  • lifestyle

Before making a choice, you should research the pros and cons of both birth control methods and then have a conversation with your doctor to determine what’s right for you.

The birth control shot, Depo-Provera, is a hormonal injection that prevents unplanned pregnancy for 3 months at a time. The hormone in this shot is progestin.

The birth control shot works similarly to the birth control pill. It prevents ovulation — or the release of an egg from the ovary — and increases the mucus buildup around the opening of the cervix.

For a successful pregnancy to occur, an egg must be released into the fallopian tube and then fertilized by sperm, which travels through the cervix (the opening on the bottom of the uterus). That fertilized egg must then travel down the fallopian tube and attach to the uterine wall.

When there’s no egg present in the fallopian tube, pregnancy is prevented since there’s nothing for sperm to fertilize. And when the opening of the cervix is blocked by thickened mucus, sperm can’t travel through as well. Progestin also thins the lining of the uterus, which prevents a fertilized egg from sticking to the uterine wall.

According to Planned Parenthood, when you receive it as directed, the shot is 99 percent effective. To ensure optimal effectiveness, you should get the shot every 3 months as directed. If you have your shot on time without being late, there’s less than a 1 in 100 chance you’ll become pregnant during a given year.

For those who don’t take the shot exactly as prescribed — often called typical use — the efficiency rate slips to around 94 percent, which means 6 out of 100 people getting the shot will get pregnant each year. Getting the injection every 12 weeks is vital to preventing unplanned pregnancy.

The birth control shot, like birth control pills, does not protect against sexually transmitted infections (STIs). You should still use a barrier method of protection, like condoms, to help prevent contracting an STI and developing a sexually transmitted disease (STD).

After your last shot, you might not return to your regular fertility. This means that you might not be able to get pregnant for up to 10 months. If you’re only looking for a temporary birth control method and wish to get pregnant soon, the shot may not be right for you.

Birth control pills are a form of hormonal contraception. Many people with a vagina use birth control pills to prevent pregnancy. The pill can also be used to:

  • reduce heavy periods
  • treat acne
  • ease symptoms of certain reproductive system issues

Birth control pills come as combination pills and progestin-only minipills:

  • Combination pills contain 2 types of hormones: progestin and estrogen. Pill packs with combination pills typically contain 3 weeks of active pills and 1 week of inactive (placebo) pills. During the week of inactive pills, you may have a period.
  • Progestin-only pill packs usually contain 28 days of active pills. Even though there aren’t any inactive pills, you may still have a period during the fourth week of your pack.

For the highest efficacy (and to help you get into a routine that leaves less room for error), you should try to take birth control pills at the same time every day, but combination pills offer more flexibility.

Combination pills are effective as long as you take one every day, but progestin-only pills must be taken within the same daily 3-hour window, according to Planned Parenthood.

Birth control pills work in 2 ways to prevent pregnancy. First, the hormones in the pill prevent the release of eggs from the ovaries (ovulation). If no eggs are released, there’s nothing for the sperm to fertilize.

Second, the hormones increase the buildup of mucus around the opening of the cervix. If this sticky substance grows thick enough, the sperm that do enter your body will be stopped before getting near an egg. The hormones can also thin the uterine lining. If an egg is somehow fertilized, this ensures it will be unable to attach to the lining.

According to Planned Parenthood, when taken as directed, birth control pills are 99 percent effective in preventing pregnancy. However, most practice what’s called “typical use.”

Typical use accounts for missing a pill or two, being a bit late with a new pack, or some other incident that prevents someone from taking the pill every day at the same time. With typical use, birth control pills are 91 percent effective, which means 9 out 100 people taking the pill will get pregnant in a given year.

It’s important to remember that birth control pills don’t protect against STIs. It’s advisable to still use a barrier method, such as condoms.

Once you stop taking birth control pills, you may return to your typical cycle almost immediately. You may experience your first regular period in as few as 2 months.

Both birth control pills and the Depo-Provera shot are very safe for most people with a vagina to use. As with any medication, these forms of birth control may have effects on your body.

For birth control pills, side effects can include:

Most of these side effects will ease within the first 2 to 3 months after you begin taking the pills.

The side effects of the birth control shot can include:

There isn’t an easy fix for any side effects you may experience because of the shot. Once the hormones are in your body, they will remain there for 3 months. You may experience side effects during this time or until the shot wears off completely.

Safety considerations

Although birth control pills and birth control shot are safe for most people, doctors may not prescribe them to everyone who’s seeking a birth control plan.

You should not take birth control pills if you:

You should not use a birth control shot if you:

How effective is the birth control shot?

When used correctly, according to Planned Parenthood, the birth control shot is 99 percent effective, meaning 1 out of 100 people will get pregnant while taking it. If you don’t get your shot on time, the effectiveness drops down to 94 percent, or 6 out of 100 pregnancies while taking it.

Is the birth control shot better than the pill?

Just like the birth control pill, there are pros and cons to the birth control shot.

One form isn’t necessarily better than the other; it comes down to your personal preferences and what’s right for you and your lifestyle. If you’re not sure which form of birth control is better for you, talk with your doctor and weigh your options before making your decision.

Will I get a period on the birth control shot?

For the first 1 to 6 months of taking the birth control shot, you’ll likely experience irregular periods. As your body adjusts, it’s possible that your periods will get lighter and shorter, and then stop altogether after 1 year (this happens to about half of people taking the birth control shot, according to Planned Parenthood.

You may also experience spotting between periods.

Do I need a prescription for the birth control shot?

Yes, you need a prescription for the birth control shot, as well as all other forms of hormonal birth control. The only exception is emergency contraception, often called “the morning after pill,” which is available without a prescription at most pharmacies.

Besides visiting a doctor in person, you can use online birth control platforms to receive a birth control pill prescription and regular deliveries.

How can I prepare for getting the birth control shot?

There’s nothing special that you have to do to prepare for getting the birth control shot. However, eating a nutrient-rich meal and making sure you’re hydrated is always a good idea.

If needles make you uneasy, let your healthcare professional know before they administer the shot. They may ask you to sit or lie down to help ease your nerves and reduce your risk of fainting.

Birth control pills and the birth control shot use hormones to help prevent pregnancy.

According to Planned Parenthood, they’re both up to 99 percent effective when taken or administered exactly as directed, but the typical use rate drops to 94 percent for birth control shot users and 91 percent for birth control pill users.

While birth control pills have to be taken every day, the shot only has to be administered once every 3 months.

Each type of birth control comes with its own set of pros and cons, and one’s not necessarily better than the other. It all comes down to what’s right for you and your lifestyle.

If you want to start hormonal birth control but don’t know which one to choose, make an appointment to discuss your options with a healthcare professional.